Xanthelasma palpebrarum represents yellowish plaques, which mostly appear near the inner cantus of the eyelid. In most patients, cosmetic reasons are the main purpose for their removal. The author presents a patient with a lower eyelid xanthelasma where surgical excision was used as a first treatment option. Cosmetic reasons, fast recovery, and possibility of a 1-stage procedure were the main requests of the patient for the removal of xanthelasma. Treatment and postrecovery period were routine. In the treatment of xanthelasma palpebrarum of the lower eyelids, it is necessary to consider surgical excision as a first treatment option. (C) 2017 by Mutaz B. Habal, MD.
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